anatomy Flashcards
foreman magnum
spinal cord,medula oblongata, 3 meninges, veins, arteries nerves, ligament of dens
cribiform bones
olfactory 15 nerves
orbital plate
3 layers - 3 fossa
cerebellum?
small brain - BALANCE, coordination, muscle tone
squamous part of temporal bone?
other parts - in medial and posterior fossa
bat bone?
superior view - greater, lesser wing, SPHENOID
four bones meet?
thinnest area, prone to injury/ fracture
frontal, parietal, sphenoid, and temporal
Ethmoid crista galli
The crista galli is a thick, midline, smooth triangular process arising from the superior surface of the ethmoid bone, projecting into the anterior cranial fossa. … Immediately lateral to it are the nasal slits where the anterior ethmoidal nerves descend into the roof of the nasal cavity.
Gomphosis tooth - periodontal ligament?
can get infected! periodontitis
A gomphosis is a joint that anchors a tooth to its socket. Gomphoses line the upper and lower jaw in each tooth socket and are also known as peg and socket joints. These joints have a very limited range of mobility so the teeth are held firmly in place.
inferior nasal concha
paired
zygomatic
2
vomer
1
mandible
1
maxilla
2
lacrimal
2
nasal
2
palatine -
2
frontal, temporal spehnoid and ethmoid- are
pnuematized - have air cells or larger sinuses
orbitometal plane
frankfort horizontal plane -
viscerocranium
facial bones - 14 irregular bones - two unpaired in midleine (mandible and vomer and 6 paired
nasal bone?
bridge, punch in face - fractures
placing skull in anatomical position
frankfurt plane
international convention to be the Frankfurt plane - a position in which the lower margins of the orbits, the orbitales, and the upper margins of the ear canals, the poria, all lie in the same horizontal plane.
What is a sinus in the skull?
The sinuses are a connected system of hollow cavities in the skull. … Your cheekbones hold your maxillary sinuses (the largest). The low-center of your forehead is where your frontal sinuses are located.
The word “sinus” is most commonly understood to be the paranasal sinuses that are located near the nose and connect to the nasal cavity. There are four paranasal sinuses, each corresponding with the respective bone for which it is named: maxillary, ethmoid, sphenoid, and frontal.
Sinuses are air-filled sacs (empty spaces) on either side of the nasal cavity that filter and clean the air breathed through the nose and lighten the bones of the skull. There are four paired sinuses in the head. The most posterior (farthest toward the back of the head) of these is the sphenoid sinus.
sinuses,
frontal bone - two spaces - not symmetrical
maxillary sinus, spenoid
ethmoid
some bones are both membrane and cartilage
petrous part of temporal - (looks like stone) - cartilage - squamous - membrane
The endocranium, the bones supporting the brain (the occipital, sphenoid, and ethmoid) are largely formed by endochondral ossification. Thus frontal and parietal bones are purely membranous.
The flat bones of the face, most of the cranial bones, and a good deal of the clavicles (collarbones) are formed via intramembranous ossification, while bones at the base of the skull and the long bones form via endochondral ossification.
frontal bone
Metopic suture
unpaired, two halves fuse by 10 - 12 years of age - some people do not fuse - netropic suture - will join two front bones - normally no suture after 12 years,
Metopic Suture: The Metopic suture which runs mid-line of the frontal bone will fuse normally with no skull defect between the ages of three(3) months of age and nine(9) months of age. Sagittal Suture: Full obliteration may never occur. The suture closes sometime between the ages of 30 years old and 40 years old.
frontal - 3 parts
The frontal bone is one of the skull bones enclosing the brain (neurocranium) and it consists of three parts:
the squamous part.
the orbital part.
the nasal part.
ethmoid sinuses - how many?
There are 3 to 4 cells at birth and develop into 10 to 15 by adulthood for a total volume of 2 to 3 mL. They are located between the eyes.
sphenoid
There are four main parts to the sphenoid bone: the body (corpus), the lesser and greater wings (alae minores et majores) and the pterygoid processes.
What are the pterygoid plates?
a : a broad thin plate that forms the lateral part of the pterygoid process and gives attachment to the lateral pterygoid muscle on its lateral surface and to the medial pterygoid muscle on its medial surface. — called also lateral pterygoid plate.
What goes through Pterygoid Canal?
The pterygoid canal, also known as the Vidian canal, is a foramen in the base of skull, located in the sphenoid bone, inferomedial to the foramen rotundum. It transmits the Vidian artery and Vidian nerve from the middle cranial fossa to the pterygopalatine fossa.
depression in body of sphenoid?
sella turcica - pituitary
hypofosall fossa
The sella turcica is located in the sphenoid bone behind the chiasmatic groove and the tuberculum sellae. It belongs to the middle cranial fossa. The sella turcica’s most inferior portion is known as the hypophyseal fossa (the “seat of the saddle”), and contains the pituitary gland (hypophysis).
articulations of frontal bone?
Glabella? the smooth part of the forehead above and between the eyebrows.
What are the landmarks of the skull?
How to palpate skull landmarks
Mastoid process. This is the big lump behind the ear lobe. …
Temporal Squama. It is mostly anterior to the ear. …
Sphenoid greater wing. …
Coronal suture, bregma and frontal eminences. …
Parietal eminences. …
External occipital proturberance.
landmarks? surfaces and landmarks of frontal bone frontal eminence (2), superciliary arch (2), glabella, supraorbital margin (2), featuring. zygomatic process (2), temporal line, temporal surface.
foramen caecam?
small depression in front of ethmoid
What is the Nasion?
The nasion (also known as bridge of the nose) is the midline bony depression between the eyes where the frontal and two nasal bones meet, just below the glabella. It is one of the skull landmarks: craniometric points for radiological or anthropological skull measurement.
septum in frontal bone?
often not in the center, open independently into lateral wall of nasal cavity
Bony septum that separate frontal sinuses and which often deviates to one or other side, with the result that the sinuses are rarely symmetrical.
superciliary?
above eye lashes - cilia - hair
parietal bone
lateral wall of cranial vault
fontanelle
replaced by bone by around 2 years
Arterial Supply to the Brain.
external carotid - branches up into
middle meningeal artery -
maxillary artery
Arterial Supply to the Brain. There are two paired arteries which are responsible for the blood supply to the brain; the vertebral arteries, and the internal carotid arteries. These arteries arise in the neck, and ascend to the cranium
What arteries supply blood to the brain?
The brain receives blood from two sources: the internal carotid arteries, which arise at the point in the neck where the common carotid arteries bifurcate, and the vertebral arteries (Figure 1.20). The internal carotid arteries branch to form two major cerebral arteries, the anterior and middle cerebral arteries.
zygomatic bones
cheek - malar bones
has proesses - one that goes above - frontal process, and posterior - temporal process
zygomatic facial foramen
on lateral surface of bone, articulartes with maxilla, and temporral and frontal
forms lateral and floor of orbit?
zygomatic
nasal bone? vomar?
forms pyriform aperture - PEAR shapes, other border, maxilla
the small, thin bone separating the left and right nasal cavities
maxilla - above the lips to nasal and?
zygomatic
maxilla
The maxilla forms the upper jaw by fusing together two irregularly-shaped bones along the median palatine suture, located at the midline of the roof of the mouth
3 Alveolar Bone. The alveolar bone is that part of the mandibular and maxillary bone which surrounds the teeth and forms the tooth sockets. The bone of the tooth socket is a dense cortical plate into which the principal fibers of the periodontal ligament are inserted, referred to as Sharpey’s fibers.
has sockets - alvelar margine - BOMA - nasal crest, suture intermaxiliary suture, paired bone, maxillary air sinus in upper part
maxillary sinusistis
is so much fluid can’t drain out - can see on xray
Maxillary Sinusitis is the inflammation of the paranasal sinuses caused by a virus, bacteria, or fungus. The infection can also result after an allergic reaction – when the immune system attacks the healthy body cells. This infection may be associated with both bacterial and fungal infections.
maxilla processes
is a paired bone that has a body and four processes: frontal process, zygomatic process, palatine process, and alveolar process. The two maxillary bones (maxillae) are fused in the midline by the intermaxillary suture to form the upper jaw.
fractures of maxillae Le FORT type 1, 2, 3 - see screen shot
horizontal
pyramidal (2)
3 - along nose to cheeks - most common ? most severe type 3 - least common
The term LeFort fractures is applied to transverse fractures of the midface. … Le Fort I level fractures are essentially a separation of the hard palate from the upper maxilla due to a transverse fracture running through the maxilla and pterygoid plates at a level just above the floor of the nose
Who was Le Fort?
René Le Fort (1869-1951) was a French army surgeon who conducted a series of thorough, if somewhat macabre, experiments on the heads of cadavers. The results of his work gave rise to a system of classifying facial fractures, now known as Le Fort types I, II and III..
type 1 - involves nose - epitaxis - (bleeding from nose
see also in type 3
mandible -
The mandible, or lower jaw, is the bone that forms the lower part of the skull, and along with the maxilla (upper jaw), forms the mouth structure. Movement of the lower jaw opens and closes the mouth and also allows for the chewing of food. The lower set of teeth in the mouth is rooted in the lower jaw
two parts Body and reaches up - ramus (branch) - juncture of two parts is angle, and mandibular notch, temporal mandibular joint, head of mandible, = BICONDALAR joint - they act together
in front of notch - coronoid process
mandibular foraman - nerve going thru? inferior alveolar nerve - goes thru sockets of lower job - sensation of teeth
mental protuberance of foraman?
The mandible is marked by two foramina. The mandibular foramen is located on the internal surface of the ramus of the mandible.
What passes through the mental foramen?
The mental foramen is a small foramen on the anterior surface of the mandible, typically adjacent to the root of the mandibular second premolar tooth. … The mental nerve, a terminal branch of inferior alveolar nerve and the mental artery leave the mandibular canal through it.
foramen of chin - “mental” means chin
The mandibular foramen is a bony canal formed within the mandible. This bony canal opens on the inner side of the mandibular ramus. The opening is directly inferior to the mandibular notch and ends at the mental foramen. The foramen follows the shape of the mandible.
The mandibular foramen will house and protect the inferior alveolar nerve. This nerve provides innervation to the gums, dental sockets, and teeth. The inferior alveolar nerve innervates the anterior chin and lower lip via the mental nerve.
mandible fuses by age ?
What does the mandibular nerve do?
2
Motor Functions. The mandibular nerve is the only branch of CN V to conduct motor axons to the muscles of the head and neck. The motor root of the trigeminal nerve joins the sensory component distal to the trigeminal ganglion and distributes its axons to the muscles of mastication: Masseter.
Mandibular fractures
below canine tooth
are typically the result of trauma. This can include a fall onto the chin or a hit from the side. Rarely they may be due to osteonecrosis or tumors in the bone. The most common area of fracture is at the condyle (36%), body (21%), angle (20%) and symphysis (14%).
superciliary arch injury?
What is an orbital floor fracture?
An orbital blowout fracture is a traumatic deformity of the orbital floor or medial wall, typically resulting from impact of a blunt object larger than the orbital aperture, or eye socket. … They can occur with other injuries such as transfacial Le Fort fractures or zygomaticomaxillary complex fractures.
causes black eye - blood goes in above eye -
malar flush/rash
zygomatic bone - cheek, reddish in systemic lupus
infratemporal fossa and temporal fossa?
What is the temporal fossa?
The temporal fossa is a shallow depression on the side of the skull bounded by the temporal lines and terminating below the level of the zygomatic arch.
Where is the temporalis muscle?
Temporal muscle. The temporalis muscle is a thin, fan-shaped muscle situated within the temporal fossa of the skull. Along with the medial pterygoid, lateral pterygoid and masseter muscles, it belongs to the group masticatory muscles.
The infratemporal fossa is a space that exists below the temporal fossa. When seen on the skull without the soft tissues, these two anatomical landmarks can be seen to communicate with one another. The fossa is shaped irregularly and is situated below and medial to the zygomatic arch.
external acoustic opening
external ear and middle ear - membrane - vibrates -
External auditory canal, also called external auditory meatus, or external acoustic meatus, passageway that leads from the outside of the head to the tympanic membrane, or eardrum membrane, of each ear. The structure of the external auditory canal is the same in all mammals.
where four bones meet?
pterion
The pterion is the region where the frontal, parietal, temporal, and sphenoid bones join together. It is located on the side of the skull, just behind the temple. ... It is the junction between four bones: the parietal bone. the squamous part of temporal bone. the greater wing of sphenoid bone. the frontal bone.
skull fractures
There are four major types of skull fractures, including the following:
Linear skull fractures. This is the most common type of skull fracture. …
Depressed skull fractures. This type of fracture may be seen with or without a cut in the scalp. …
Diastatic skull fractures. …
Basilar skull fracture.
depression, baselar, linera calvarial, comminutes, contrecoup (counterblow)
a coup injury occurs under the site of impact with an object, and a contrecoup injury occurs on the side opposite the area that was hit. Coup and contrecoup injuries are associated with cerebral contusions, a type of traumatic brain injury in which the brain is bruised.
subdural - shaken baby - crescent - bridging veins
location of pterion?
can form with your fingers - middle meningeal vessel lies here - can get torn
middle meningeal artery - maxillary artery - external carotid
Where is the middle meningeal artery located?
The middle meningeal artery runs through the foramen spinosum, underneath the temporal bone at the side of the head, and above the dura mater, a layer of protective brain tissue.
Is the middle meningeal artery an intracranial artery?
The middle meningeal artery is the largest of the three (paired) arteries that supply the meninges, the others being the anterior meningeal artery and the posterior meningeal artery.
through various foramen
maxillary artery
The middle meningeal artery (MMA) normally branches off the maxillary artery, which is an extension of the external carotid artery. The artery will then travel through the foramen spinosum, which is posterolateral from the foramen ovale, to supply blood to the dura mater.
if fractured?
Epidural hematoma is when bleeding occurs between the tough outer membrane covering the brain (dura mater) and the skull. Often there is loss of consciousness following a head injury, a brief regaining of consciousness, and then loss of consciousness again.
epidural hematoma - can die - may have a lucid period, and then die - can happen quickly
How common are epidural hematomas?
Intracranial epidural hematoma occurs in approximately 2% of patients with head injuries and 5–15% of patients with fatal head injuries. Intracranial epidural hematoma is considered to be the most serious complication of head injury, requiring immediate diagnosis and surgical intervention.Jan 9, 2018
clot in this types of case?
lemon shaped - convex on both sides - epidural or extidural hemorrage - fracture at pterion, middle meningeal - don’t do lumbar puncture - can cause hermiation of brain thru foramen magnum, would reduce pressure brain would herniate down thru foramen - would compress foram
in elderly people - larger space around brain, brain shrinks
subdural hemorrage -
A subdural hemorrhage (or hematoma) is a type of bleeding that often occurs outside the brain as a result of a severe head injury. It takes place when blood vessels burst between the brain and the leather-like membrane that wraps around the brain (the dura mater).
shaken baby
brain can get injured -
subdural hemorrage - SLOW bleed from brain - and then can all of a sudden become confused
Causes of Subdural Hematoma
Subdural hematoma is usually caused by a head injury, such as from a fall, motor vehicle collision, or an assault. The sudden blow to the head tears blood vessels that run along the surface of the brain. This is referred to as an acute subdural hematoma
subarachnoid
thunderclap headache
circle of willis can rupture -
Subarachnoid hemorrhage (SAH) is a life-threatening type of stroke caused by bleeding into the space surrounding the brain. SAH can be caused by a ruptured aneurysm, AVM, or head injury.
bleeds into space where CSF exists - aneurysm - thunderclap headache
A thunderclap headache is an extremely painful headache that comes on suddenly, like a clap of thunder. This type of headache reaches its most intense pain within 1 minute and lasts at least 5 minutes. Thunderclap headaches strike without any warning. Some of these headaches are benign (not dangerous).
cerebral hemorrage
arteries rupture - high blood pressure, can stroke
Cerebral hemorrhage is uncontrolled bleeding in the brain. It can occur from an injury or as a result of a leaky or burst blood vessel. This can happen when a blood vessel gets weakened enough that its wall can no longer withstand the pressure of the blood flowing through it.
cerebral hemorrage
intracerebral hemorhage
arteries rupture - high blood pressure, can stroke
Intracerebral hemorrhage (ICH) is caused by bleeding within the brain tissue itself — a life-threatening type of stroke. A stroke occurs when the brain is deprived of oxygen and blood supply. ICH is most commonly caused by hypertension, arteriovenous malformations, or head trauma.
shapes of clots
biconvex, lemon
banana subdural - venous - slow - bridging vein, in elderly
occipital - inion
tip of the external protuberance - occipital crest
Occipital inion
The inion (plural: inia/inions) is the tip of the external occipital protuberance (EOP), the midline bony prominence in the occipital bone from which the ligamentum nuchae and trapezius muscle attach. It is usually easily palpable. It is the surface marking of the internal attachment of the tentorium cerebelli.
lambda suture -
accessories bones - wormian bones - islands of bone at suture
anterior fontanelle
other sutures related to parietal bone
sagital suture
parietal forament
emissary foramina
The skull bones that contain foramina include the frontal, ethmoid, sphenoid, maxilla, palatine, temporal, and occipital. There are 21 foramina in the human skull.
emissary veins, connecting scalp veins to venous sinuses of dural mater
infections can travel from out to in
An occipital emissary foramen has been traditionally described as a foramen present in the squamous part of the occipital bone at the occipital protuberance transmitting a vein that connects the confluence of sinuses with the occipital vein. .
palatine process
hard palate, palatine bone, lateral wall of nasal cavity, occipital bone,
In human anatomy of the mouth, the palatine process of maxilla (palatal process), is a thick, horizontal process of the maxilla. It forms the anterior three quarters of the hard palate, the horizontal plate of the palatine bone making up the rest.
sphenoid
a compound bone that forms the base of the cranium, behind the eye and below the front part of the brain. It has two pairs of broad lateral “wings” and a number of other projections, and contains two air-filled sinuses.
body, greater wings, air sinuses, pteygoid processes, supeior orbital fissure, two processes down - lateral and medial pterygoid plate
groove for auditory tube?
pharyngotypanic tube? - between ear and throat - equalize pressure not for equilibrium, just for equalizing pressure
eustacian tube?
The eustachian tube is a canal that connects the middle ear to the nasopharynx, which consists of the upper throat and the back of the nasal cavity. It controls the pressure within the middle ear, making it equal with the air pressure outside the body.
pharynogotympanic tube - maintains equal pressure - if blocked, can cause drop in pressure, can be painful
temporal bone
petrous part, squamous, styloid, tympanic part -
houses middle ear
The temporal bones are situated at the sides and base of the skull, and lateral to the temporal lobes of the cerebral cortex. The temporal bones are overlaid by the sides of the head known as the temples, and house the structures of the ears.
base of cranium - foramen magnum
The foramen lacerum is filled with connective tissue and transmits the small meningeal branches of the ascending pharyngeal artery and emissary veins from the cavernous sinus to the pterygoid venous plexus. The internal carotid artery passes along its superior surface but does not traverse it.
The artery of pterygoid canal, the nerve of pterygoid canal and some venous drainage pass through the foramen lacerum. In the foramen lacerum the greater petrosal nerve joins with the deep petrosal nerve to form the nerve of the pterygoid canal.
spinal cord, meninges, vertebral arteries, anterior and posterior spinal arteries, accessory nerve CN XI
Its contents include the medulla oblongata, meninges, spinal root of cranial nerve XI, vertebral arteries, anterior and posterior spinal arteries, the tectorial membrane, and alar ligaments.
meninges? the three membranes (the dura mater, arachnoid, and pia mater) that line the skull and vertebral canal and enclose the brain and spinal cord.
bell’s palsy?
The stylomastoid foramen is between the styloid and mastoid processes of the temporal bone. It is the termination of the facial canal, and transmits the facial nerve and stylomastoid artery.
what foramen? styloid mastoid foramen
Swelling and inflammation of the cranial nerve VII is seen in individuals with Bell’s palsy. Most scientists believe that reactivation of an existing (dormant) viral infection may cause the disorder
foramen spinosa
The foramen spinosum is one of two foramina located in the base of the human skull, on the sphenoid bone. It is situated just anterior to the spine of the sphenoid bone, and just lateral to the foramen ovale.
what passes thru? epidural hemorrage, middle menengial artery
The foramen spinosum (plural: foramina spinosa) is located in the posteromedial part of greater wing of sphenoid bone posterolateral to foramen ovale which connects the middle cranial fossa with the infratemporal fossa. It transmits the middle meningeal artery, middle meningeal vein, and (usually) the nervus spinosus.
accessory nerve?
the accessory nerve is a motor nerve that supplies the sternocleidomastoid and trapezius muscles. Some texts consider the ‘cranial’ root, which arises from the caudal portion of the nucleus ambiguus, as part of the accessory nerve.
where do vertebral arteries come from?
The vertebral arteries arise from the subclavian arteries, one on each side of the body, then enter deep to the transverse process at the level of the 6th cervical vertebrae (C6), or occasionally (in 7.5% of cases) at the level of C7. They then proceed superiorly, in the transverse foramen of each cervical vertebra.
6 foraman - and the magnum
through all the cervical vertebra doesn’t go thru C7 - (7 cranial cerves)
accessory nerve
goes up and then comes down to supply trapezius and cor sterno?
jugular foramen?
Cranial nerves IX (glossopharyngeal), X (vagus) and XI (accessory) and the inferior petrosal sinus and sigmoid sinus vein pass through the jugular foramen.
internal jugular - biggest vein in neck - and several cranial nerves = 9, 10 and 11 (accessory) close to vagus - now described as nerve all by itself
carotid canal
styolomastoid foraman facial nerve 7 and stylomastoid artery - posterior
internal carotid artery
Carotid canal and foramen lacerum
The internal carotid artery passes from the carotid canal in the base of the skull, emerging and coursing superior to foramen lacerum as it exits the carotid canal. … The segment of the internal carotid artery that travels above foramen lacerum is called the lacerum segment.
mastoid process -
muscle attachements
a conical prominence of the temporal bone behind the ear, to which neck muscles are attached, and which has air spaces linked to the middle ear.
anterior, middle and posterior fossa
anterior cranial fossa fractures
anterior - themoid, cock’s comb
Presentation with anterior cranial fossa fractures is with CSF rhinorrhea and bruising around the eyes, ie, “raccoon eyes.” Loss of consciousness and Glasgow Coma Score may vary depending on an associated intracranial pathologic condition.
olfacotry rootlests pass thrug?
The olfactory nerve is actually a collection of sensory nerve rootlets that extend down from the olfactory bulb and pass through the many openings of the cribriform plate in the ethmoid bone. … Olfactory bulb cells then transmit electrical activity to other parts of the central nervous system via the olfactory tract.
turkish saddle?
Within your skull, there’s a small, bony nook at the base of your brain that holds and protects your pituitary gland (which controls how hormones work in your body). This tiny structure is called the sella turcica.
The sella turcica is located in the sphenoid bone behind the chiasmatic groove and the tuberculum sellae. It belongs to the middle cranial fossa. The sella turcica’s most inferior portion is known as the hypophyseal fossa (the “seat of the saddle”), and contains the pituitary gland (hypophysis).
middle cranial fossa
hypophysial ?
Turkish saddle bone
The sella turcica (Latin for Turkish seat) is a saddle-shaped depression in the body of the sphenoid bone of the human skull and of the skulls of other hominids including chimpanzees, orangutans and gorillas. It serves as a cephalometric landmark.
prechiasmatic sulcus
optic canals
foramen rotundum
maxilliary nerve
cranial fossa
floor of cranium, 3 sections
anterior
middle
posterio
The anterior cranial fossa
is a depression in the floor of the cranial base which houses the projecting frontal lobes of the brain. It is formed by the orbital plates of the frontal, the cribriform plate of the ethmoid, and the small wings and front part of the body of the sphenoid; it is limited behind by the posterior borders of the small wings of the sphenoid and by the anterior margin of the chiasmatic groove. The lesser wings of the sphenoid separate the anterior and middle fossae.
The middle cranial fossa,
deeper than the anterior cranial fossa, is narrow medially and widens laterally to the sides of the skull. It is separated from the posterior fossa by the clivus and the petrous crest.
The posterior cranial fossa
is part of the cranial cavity, located between the foramen magnum and tentorium cerebelli. It contains the brainstem and cerebellum.
four cranial sutures of note
neurolcranium
sagital
coronal
lambdoid
squamous (2)
8 bones of skull
4 singular
2 pairs
frontal
ethmoid
bat bone - sphenoid
occipital
temporal
parietal
frontal
3 parts
squamous - largest - forehead
orbital
nasal
ethmoid
separates brain from nasal cavity- also part of viscerocracium - (orbit, nasal cavity, nasal septum)
spenoid
small on outside - part of temporal fossa, big inside
body
lesser wings (optic canal
greater wings - on outside w/ temporal bones
pterygoid process- muscles originate
occipital
only bone articulating with cervical spine -
and with parietal bones
4 parts
basal part - anterior to foramen magnum
2 condylar - articulating with atlas vertabrae
sqaumous
foramen magnum
brain stem
accessory nerve (spinal branch)
anter/post spinal artery
vertebral artery
spinal vein
paired bones -
temporal
2 parts - squamous (larger upper part - part of temporal fossa)
lower part - petrous
4 features
mastoid process
styloid process
zygomatic process
ear area - timpanic
ethmoid
divides nasal cavity - betwe left and right
nasal cavity begins at …
vomar
forms inferior and posterior portion of nasal septum
mandible -
attached to temporal via TMJ - not articular with other bones via suture -
(modified hinge joint)
body rami condolar processes coronoid process alveolar process (teeth)
nasal bones
from bridge
articular with ethmoid posteriorly
maxilla - upper jaw
four parts
frontal process
zygomatic
orbital surface
palantine surface
nasal cavity - 3 conchi - inferior is considered its own bone
warm, clean, humidify superior and middle - considered part of neurocranium - and part of ethmoid bone
zygomatic - cheek
form inferior, lateral of orbit
frontal process
temporal process
maxilary part
lacrimal - smallest - most fragile
in medial wall of orbits -
foramen - tear ducts -
palantine bones
3 parts
horizontal plate (joins with maxilla palatine process - forming hard palate)
perpendicular plate
pyramidal process
posterior cranial fossa
clivis? incline leading to foramne magnum
anterior cranial fossa
3
foramen cecum - nasal emissary vein 1%)
can get infections
cribriform plate of ethmoid (for nerve rootlets)
anterior and posterior ehmoidal foramina -
middle cranium fossa
optic canal - optic nerve 2nd and opthalmic arteries - branch of internal carotid
superior orbital fissure - opthalmic veins - CNv1 (first branch of trigem nerve) brings in sensation - not visual from orbit -
CN 3, 4, 6 and sympathetic fibers -
supply extraocular muscles -
3 - muscle within eyeball - interocular m.
doesn’t supply all nerves - but parasympathetics -
foramen rotundum
maxillary nerve - CN v2 (2nd branch of trigem nerve) sensory
v1 and v2 are sensory- v3 mostly sensory, has small motor nerve
foramen ovale - mandib nerve CN v3 and accessoroy memingeal artery
foramen spinosum - middle meningeal artery and vaein and CN v3 (sensory
foramen lacerum - internal cartoitd artery and its sympathetic and venous pleusus
rough edges - lacerated - venous plexus
pass above not thru foramen lacerum - upper part is open, lower part closed with cartilage
two big arteries in crani
internal carotid - gives no branches out side of cranial cavity - comes thru?
foramen lacidum?
two big arteries in cranium ? not sure this is true
internal carotid - gives no branches out side of cranial cavity - comes thru?
posterior cranial fossa
foramen magnum - medulla and meingese - CN 11, dural veins, anterior and posterior spinal arteries
MOTOR
CN 11 - comes up - thru ? internal tubular vein
jugular foramen
CN 9, 10, 11 - superior bulb of internal jugular vein, inferior petrosal and signmoid sinueses and meningeal branches of ascending pharyngeal and occipital arteries
Hypoglossal canal CN 12
condylar canal - emisseary vein from signmoid sinus to vertebral veins in neck
mastoid foramen - mastoid emissary vein from sigmoid sinus and meimgeal branch of occipital artery
Hypoglossal canal CN 12
all of tongue but ?
serious skull fracture signs?
bleeding - eyes, ears, nose
bruising - under or behind ears
severe pain
swelling, red, warmth, bleeding
headaches get worse, weakness decreased coordination, repeated vomiteing restless ness irritablity - meningitis, loss of balance - vestibular damage, confusion
concussion (minor head trauma
defined as temporary loss of brain function -
headache or feeling of pressure, temp loss of conscioulness, confusion, felling in fog, amnesia, dissizness, seeing starts, ringing in ear, nausea, vmoiting slurred speech delayed response , fatigue
skull fracture
xray or CT scan -
treaement depending upon details -
pain
surgery - if hematoma - drainage reduce pressure, osmotic diuretics mannitol to reduce brain edema
all surgical intervention can be used to reduce fractures
back at 11 AM - Infratemporal fossa~
mandibular nerve, temporalis m
temporalis M
where is it? inferior part of temporal m and lateral and medial pterygoid muscles and maxillary arter - are in the the infratemporal fossa
12 cranial nerves
which is biggest - trigeminal -
opthalmic v1
v2 maxillary - both sensory
v3 - mandibular - mixed
four muscles to masticate
all inserted into mandible - they move the mandible
all supplied by mandibular nerve -
mandibular nerve
supplies teeth -
goes thru mandibular foramen
inferior alveolar nerve
come out of mental nerve
posterior division of mandib nerve - sensory
one exception - not sensory - mylohyoid sp? nerve and supplies another m too
mandib - nerve - anterior - mainly motor
buckle nerve - exception - sensory cheek
infratemporal fossa - complicated
plexus of veins - around pterygoid -
nerve supply of masticaion?
mandibular v 3
muscles of facial expression
facial nerve VII
muscles of mastication?
mandib nerve V- v3
biggest branch of trigem nerve?
mandibular, passes thru ovale fission
4 parasympathetic ganglia?
psteryto - TEARS - in space communicating in intratemporal fissure
maxillary nerve - thru rotunda - ganglion here - pterytopalantine ganglion also called spenoipalatine ganglion -
functions TEARS
masseter mucles
not in intratemp fossa - other 3 muscules of mastication are
Pterygoid plexus of veins
if infection - very serious-
don’t have valves - infections can travel into cranial cavity - brain no lymphatics - if infection in brain - can be catastrochpin
facial vein -
deep facial vein - with pterygoidal plexus
cavernous sinus
veins inside of brain - “venous sinuses”
deep facial vein goes into brain, and
emissary vein - two veins into brain - from ptserygo plexus to cavernous sinus
two venous sinus ?
sigmoid sinus
inferior petro sinus
nerve to tongue
lingual nerve - - sensation of tongue - hypo? supplies all movement to tongue
tongue has how many nerves?
about 7…
two types of sensation -
general, and special sense
two types in orbit?
vision
temp, touch pain, vibraion - general sensation
general vs special
lingual nerve -
fibers have general and special -
special sense - carried by another nerve - hitchhiking along - chorda tympani - part of facial vein
lingual nerve -
chorda tympani
fibers have general and special -
special sense - carried by another nerve - hitchhiking along - chorda tympani - part of facial vein
if tympanic nerve injured
branch of facial nerve VII, brings taste sensation - 2/3 of tongue
hot cup of coffee
hot - lingual
vs tasty
tasty- chordai timpani
chordai Tympani nerve - somatic or autonomic?
parasympathetic and taste (somatic)
supplies 2 glands
combo parasympathetic and sensory
nerve goes to gland - submandibular gland - back to nerve, and then back to sublinguial gland
otic ganglion
infratemporal fossa
otic ganglion
submandibular gland -
What are the four ganglia?
COPS
hang on like decorations on a tree
4 - COPS C - ciliary o- otic (near ear) P - pterito (tears) - two names S - submandibular
all ganglia - hanging on a tree - the trigeminal nerve -
they belong to other nerves
pterioto ganglia
tears - VII - gland secretes tears - lacrimal gland - hitchhikes along trigem nerve -
maxillary nerve
otic ganglia
parasympathe - glosophayneal - jugular foramen -
parotid gland
biggest salivary gland - near ear
supplies gland
hangs on to oriculartemporal -
ciliary ganglion
3rd nerve parasympathetics -
via trigeminal nerve
maxillary artery
medial to maxillary bone
branches
of external cartoid
artery 3 parts
inferior alveloar artery - foreman mandib -
all muscles of mastication -
temporalis
2
and cheek
buckle nerve -
sensory to cheek - comes from trigeminal
buckle artery along w/ it
intraorbital nerve? at fissure
continuation of max nerve
yawning…
carbon dioxide
lateral pterygoid - depresses mandible - pull it down, mouth open
excess carbon dioxide in pteryo plexus
around lateral telligoid - causes yawning - depression of mandible - one f only four muscle that cause dperession - lateral pteryiogoid
mandibular nerve
through foramne ovale - anterio and posterio division
anterior - mostly motor - exc
posterior - mostly sensory - exc
branches of CN v3
otic ganglia involved
parotid gland
auricolutemporal, inferior alveolar, linguial, and buccal nerve
two roots -
artery goes upward - middle meningeal artery
inferior alveolar nerve
tooth ache
lingual nerve
general sense
tongue - not special sense -
buccal nerve
cheek
v3 four mu of mastication
masseter
temporalis
medial pterygoid, lateral pterygoid - but not the buccinator - which supplied by facial
four ganglia
most important are parasympathetic nerves
submandibular duct - lingual nerve
nerve related - lingual nerve - if duct has a stone - be careful to not hard lingual nerve
lesser petrosal nerve -
3 pathways -
goes to partoid - MUMPS - auricultotermporal nerve carries the pain - T1 spinal segment re sympathetics
3rd molar - wisdom tooth
Lingual nerve nearby - can damage when removing wisdom!
medial pterygoid muscle - ramus of mandible
mandibular nerve block.
extraoral approach - need passes through mandibular notch of ramus of mandible into infratremporal fossa - extensive effect =
What muscle opens the jaw?
Unlike the other three muscles of mastication, the lateral pterygoid is the only muscle of mastication that assists in depressing the mandible (opening the jaw). At the beginning of this action it is assisted by the digastric, mylohyoid and geniohyoid muscles.
ooottafvgvah
show tongue
open mouth
cough
burnt tongue
The three nerves associated with taste are the facial nerve (cranial nerve VII), which provides fibers to the anterior two-thirds of the tongue, the glossopharyngeal nerve (cranial nerve IX), which provides fibers to the posterior third of the tongue, and the vagus nerve (cranial nerve X), which provides fibers
olfactory - smell
optic - sight
opto… muscles of eye + para pupil
th muscles of eye
trigleminal - biggest
v1 sensory - face/nasal
v2sensory - face / nasla
v3 - motor and sensory
aducem muscles of eye
facial + para facial expressions, TASTE 2/3
veriauditory ear and balance
glossopharyn + para - taste 1/3 posterior SORE THROAT< EAR ACHE
vagus + para cough, swallow, taste 1/3 posterior
accessory - rotate head, shrug shoulders
hypglossal - tongue movement
blink an eye?
5 and 7
gag reflex
cranial nerves 9 and 10
trigeminal?
the ophthalmic nerve (V1), the maxillary nerve (V2), and the mandibular nerve (V3).
notes from class July 23
lingual nerve - deaded in wisdom tooth extraction
scalp - 5 layers
nuchal lines on occipital bone thru parietal, to frontal
covers temporal fascia
skin CT apolneurosis (epicranial) Loose areolar tissue Pericranium
SPALP
occipital frontalis
muscle of epicranial aponeurosis
first three layers -
move as one unit
skin
often lots of hair - -
connective tissue connects skin layer to aponeurosis
dura
folds of dura - meningeal dura - where separates from bone - venous sinus -
two layers of dura -
inner
outer -
epidural hemorrage - between bone and periotial dura
arachnoid matter below this and deep to that - vascular layer on brain - PIA
thin skin also called?
periskin - has sweat and sebaceous glands, and hair follicles,
abundant arterial supply, good venous and lymphatic drainage
Connective tissue layer
blood vessels anastamose with each other - if one cut and ligated - the other side can bleed profusely
will heal quickly
aponeurosis -
attachement for muscle bellies - occipito frontalis, and temporoparietalis and superior auricular
veins - emissary veins - “messenger” veins
biconvex - lemon (epidural)
crescent - subdural hem.
can transfer blood from CT from scalp thru bone - subdural hemorrage - below the dura
venous hemorrage - occurs slowly -
nerve - 7
muscles of facial expression -
other muscles of face?
mastication muscles - 5 - v3?
muscles that move auricle?
inside ear - VIII - but only sensory
facial muscles - 7th
outside of skull
sensory innervation of scalp? as opposed to the MOVING of the scalp
scalp VII moves scalp
sensory - supratrochlear v2,
supraorbital - v1
auriculotemporal nerve?
from where to what? parasympatheitc involved - from IX -
only ventral from ?
plexuses - 4 -
4 is a big deal number
cervical 1 -4
?
?
sacral L4 - S 4
greater occipital nerve - back of head - C2
dorsal rami - doesn’t come from a plexus - C2 -
does C1 have a dermatome? NO skin is supplied to C1 - but C2 is a huge one
overshoulder? which is this one? C4
diaphragm C4
arteries in skull
supraorbital artery (w/ nerve) and supraorbital nerve (same artery)
nerves from 5 coer up to vertex - top of head
v2 climbs up side zygomatic -
v3 - mandibular - auricular -
Lesser occipital nerve
c2 and c3 - scalp back of ear
Greater occipital nerve - back of head - c2
superficial temporal artery?
in front of ear heading up to scapl
great auricular nerve?
c2, c3 - ant rami - external ear - from cervical plexus
nerve at side of neck?
all nerves emerge - only four cutaneous of cervical plexus - SUPRACLAVICULAR nerve - 3 branches - below angle of louis -
sternomastoid muscle
runs up neck - divides neck in two - this is where the great auricle nerve runs up
four direction of nerve - one down toward angle of louis
arteries of scalp - branches of opthalmic artery
Branch of internal carotid -
super trochlear
supra orbital, etc
supratrochlear, supraorbitall
most important branch - central artery of retina - immediate blindness
internal carotid
no branches before in cranium
branches of scalp
all from external carotid
posterior auricular nerve? branch of facial - supplies occipital belly of ?
supplies muscle - not a sensory nerve - so not see it on scalp, but do see the artery with same name
posterior auricular artery branch of ?
occipital artery from external carotid
external carotid - 8 branches -
external ends by dividing into superficial and inferiorly?
8 branches of external carotid artery?
occipital -
posterior?
external carotid arter -
gives branches most outside of cranium
external or internal carotid?
which is medial - external
internal jugular vein - runs down
formed by union of sigmoid sinus and inferior petrosal sinus
artery running along cheek?
transverse facial artery - branch of superficial temporal artery
venous drainage of scalp?
retromandibular vein - unusually divides into two - posterior seciton divides and ??
posterior auricular vein - unites with
lymph drainage?
submandibular, superficial parotid, around ear - mastoid nodes - back of scapl drain into occipital nodes
lymph - deep
along jugular vein
retromandibular vein?
union of superficial temporal vein and maxillary vein - divides into posterior (joins occipital) and anterior division
scalp wounds?
can gape depending upon location - and how they lie -
anterior posterior not gape so much -
gape widely if coronal
loose connective tissue - danger area of scalp
Layer 4 - travels via emissary veins
infection can spread - in areolar tissue - potential space, bleeding can track downward into eyelids - black eye - can be due to scapl injury -
veins -
bridging? from surface of cerebellum, bridges over dura - gives rise to subdural hemorrahe
emissary vein travel thru the scalp bones then down from there are the cerebral veins
if infection in scape -
can’t go to neck because occipital bellies of ?
infections can spread to certain areas - and not spread to others
?
vii - mostly motor or sensory?
mostly motor - muscles of facial expression and 4 muscles?
v - supplies what muscles
muscles of mastication -
and four other muscles
blackeye treatment
check for bleeding
vomiting
subaceous cyst
first layer - in skin
treatment - can drain - not serious
face
next power point
growth of bones
takes longer than calvaria -
trigeminal nueralgia?
severe pain on face - artery sits right on nerve - we saw the video - called suicide disease
facial artery comes from external artery
type of course?
has a tortuous course (like the splenic) - as does the uterine artery - allow expansion, movement
trigeminal
see drawing - opthalmic head to tip of nose
maxilarry - outside of eyes down to alars of nose
mandibular
temporal to chin
skin under ear and jaw “angle of mandible”
great auricular nerve
greater occipital nerve, third occipital, lesser occipital
great auricular nerve
all of these on back and side of head
shingles aka herpes zoster
viris, in nerves, nerve roots - can flare up - like chickenpox - affects one nerve root
muscle can move ear?
auricular muscles - 3
upper eyelid?
infratrochlear nerve
occipital muscle
scalp m
raise eyebrows - different bellies - and wrinkle skin of forehead
scalp m - facial muscle -
facial mus - all located in superficial fascia
inserted into dermis
in limbs - only one - palmaris brevis in hypothenar emminence
where do these m come from? pharangeal arches - 2nd arch
migrated from gut to face -
which arch - 2nd arch
tongue muscle - anterior 2/3 of tongue
chordate timpani - taste VII CN - joins lingual nerve - and supplies two glands - submandibular glands and ?
lingual nerve - HOT -
superior nuchal line?
junction of neck and ?
scapl
3 move as one
after that - 4th layer -
if in 2nd - dense CT - lots of bleeding - difficult to control
SCALP pericranium
loose aerolar CT and pericranium layer?
can spread via emissary veins - widely and deep infection spread - can go into orbit - hence raccoon eyes
loose CT dangerous layer of scapl - infection can spread widely - not highly vascularized -
pericranium trauma during birth?
Qifal hematoma
not serious - caput succadeneum
hematoma is serious
but if bleeding - deep to periostium - that can be serious - sever pressure - bleeding limited by junction of fibrous tissue w/ pericranium - to shape of bone -
Plagiocephaly
different shape of skull
surgery to parotid gland?
easy to injure facial nerve
within parotid gland -
meat in the paraotid sandwich
the meat in the parotid sandwich - facial nerve
Posterior Auricular - runs with artery
from facial to behind ear - and occipital belly -
Posterior Auricular artery - branch of ?
external carotid artery - variety of branches - need to learn
orbicularis oculi
two types - blink and wink
closes eyelids - wink or close gently - two parts of muscle - one part in eyelid - blinking - to keep cornea moist - if dries up becomes opaque, become blind - facial nerve paralysis serious - can lead to blindness - have to tape across until neuron recovers
two types of facial nerve paralysis
Lower motor neuron
Lower motor neuron lesion - damaged after it has come out of brain
every part of face affected
both halves of brain supply upper part of face, but both halves send message to upper and lower part of brain -
UPPER motor lesion - upper part of face spared - because it has bilateral nerve supply -
lower motor neuron lesion
foramen of facial - between two processes?
styloid and mastoid ?
STYLOID MASTOID FORAMEN
ipsilateral - same size - upper and lower muscles on one side all affected -
mastoid process - develops fully when
2 years old
pre 2 year old - facial nerve very superficial - susceptible to foreceps delivery -
instrumental delivery
forecepts can press - vulnerable to compression - so w/o mastoid process - less protection
edema in styloid mastoid canal
? bell’s palsy - can recover - compresses facial nerve - where nerve passes out into face
ten zebras bit my car
temporal zygomatic buccle motor nerve marginal mandibular cervical branch of facial nerve
6th is posterior auricular - not in pneumonic
orbicularis oculi - which bone near nose attached?
lacrimar
blinking vs winking
fine control - motor units
one motor unit - some go to palpable part vs tightly - vs lightly
corrugator supercilli - concern look (good for Drs to have)
not important - in superficial fascial - causes eyebrows to come together - verticle lines between eyebrowns - CONCERNED
procerus
scrunching face - disdain - wrinkles skin over nose -
alar of nasalis - flaring nostrils
anger or exertion
orbicularis oris
3 muscles need to know
buccinator
opticular oculi and oris
closes mouth - if doesn’t close - saliva trickles out - protudes lips - kissing - sphincter muscle
affected by both upper and lower parts of face
buccinator muscle
levator labili superiorori
elevates upper lip along with zygomaticus minor
buccinator - trumpeter
important when eating and blowing a trumpet
expels air - from vestibule of mouth
buccinater not included in 4 muscles of mastication
but does help
buccel nerve comes from
trigeminal, mandibular, anterior division of mandibular nerve v3
buccel nerve is sensory s…
goes w/ mandibular nerve - 5th nerve -
buccinator is supplied by ?
buccinator empties out the puffed cheeks
- 7 motor nerve - allowing you to empty air out of your cheeks
buccle NERVE is supplied by 5 - and is sensory
buccel nerve of V
is sensory
Does the buccinator muscle use 5 or 7?
7 - using the buccal branch of the facial nerve?
zygomaticus major
laughing muscle
levator anguli
angles contracti - happines with both angles, one side - disdain
risorius - something about vaccines - and parotid fascia
tetanus - causes this m to contract - sardonic smile -
risorius smile - tetanus - grimace
can be life threatening - m go into spasm, can’t breathe
grinning, grimace
boxer’s muscle?
serratus anterior - winging, medial, long throracic
if can’t stop grinning patient?
may have tetanus
depressor anguli oris
sadness, frown
depressor labii interiorois
sadness, pouting, everts lower lipe
mental nerve - branch of
to remove teeth -
inferior alvelolar nerve - can remove teeth in lower job
anesthetizes near ?foramen - and linguila nerve
mentalis nerve supply?
marginal mandibular
temporal zygomatic buccle motor nerve marginal mandibular cervical branch of facial nerve
platysma
goes down into neck -
facial m can be torn
gape - muscles pull apart - loose CT, can swell a lot, bee sting on nose may swell so much- into eyelids - can’t close eyes
scarring on face
langer lines - look for those and incise with these cleavage lines
can heal better this way too
which muscle closes eye?
orbicularis OCULI
bell palsy
same side injury
orbicularis OCULI
oris
and buccinator
three important muscles
what do they do?
The orbicularis oculi muscle lies directly underneath the surface the skin, around the eyes. Its function is to close the eyelid, and to help in the passing and draining of tears through the punctum, canaliculi, and lacrimal sac, all parts of the tear drainage system.
Orbicularis oris muscle, also known as musculus orbicularis oris is a complex, multi-layered muscle which attaches through a thin, superficial musculoaponeurotic system to the dermis of the upper lip and lower lip and serves as an attachment site for many other facial muscles around the oral region.
uccinator maintains the tightness of the cheeks and presses them against the teeth during chewing. It also assists the tongue to keep the bolus of food central in the oral cavity.
muscles of mastication and temporal mandibular joint TMJ
4 muscles - temporal masseter, lateral and medial pterygoid
4 other muscles supplied by mandibular nerve?
?
temporalis muscle?
in temporal fossa - from floor of fossa, and fascie of ?
inserts to coronoid process
(ulna too)
fibers run downward = elevation of mandible and joint,
fibers pull backward too - muscles like a fan - pull up and back
temporalis muscle?
coronoid process
retracts and pulls up
in temporal fossa - from floor of fossa, and fascie of ?
inserts to coronoid process
(ulna too)
fibers run downward = elevation of mandible and joint,
fibers pull backward too - muscles like a fan - pull up and back
artery to temporal?
artery?
nerve? auricular temporal nerve - superficial to temporalis
nerve 5, v3 supplies this - anterior division of ?
masseter
pulls up - on outside - other medial pterygoid has same action - runs inside
protraction and elevation
3 muscles elevate - which muscle doesn’t
lateral pterygoid depresses
masseter from zygomatic bone
insertion to angle of mandible and lateral surface of ramus of mandible
v3 via masseteric nerve
lateral and medial pterygoid m?
inside of mouth
lateral is in front of medial - pulls mandible forward
TMJ- two bones and a disc
“complex” - because it has a disc - bicondolar joint - like knee joint
elevation, depression (lower joint)
protraction, retraction -
upper joint cavity
Lateral pterygoid M
lateral chewing movement
v3
from pterygoid plate - of ?? spenoid? and infratemporal surface and crest of greater wing of sphenoid
insertion is complex - - attaches primarily to joint capsula and articular disc of temporromandibular joint -
medial pterygoid -
downward and backwards near masseter - deep and superficial head - same action as masseter
TMJ
modified hinge - condyle of mandible, articular tubercle of temporal bone and mandibular fossa
TMJ - has disc - two separate joint cavities
inferior - mandible fossa -
superiorly -
has fibrous capsule - synovial membrane
lateral ligament
attached to lateral pterygoid - superior and inferior head
TMJ - has disc - two separate joint cavities
near external acoustic meatus - behind -
holds head of mandible forward
inferior - mandible fossa -
superiorly -
has fibrous capsule - synovial membrane
lateral ligament
attached to lateral pterygoid - superior and inferior head
nerves of TMJ ?
foramen ovale with mandibular nerve coming out -
behind that ? spinosum w?
styloid mandibular ligament?
sphenoid mandibular ligament? - remnant of which arch? - FIRST ARCH
these two joints hold mandible in place
styloid mandibular ligament? - beginning of deep fascia - separates two glands - parotid and submandibular gland
stylohyoid lig?
remnant of 2 arch
foramen spinosum - what passes thru?
medial mengial artery ?? per ?? I think there is more
foreman ovale - what passes thru?
cnV2 cnv3 ?? per Sam?
I think there is more
hyoid?
based for tongue and ?
exception of tongue -
palatoglossal ( from vagas - not from XII0
exception of pharynyx supply by Vagas
Stylopharyngeal - The muscles of the pharynx are mostly innervated by the vagus nerve – the only exception being the stylopharyngeus (glossopharyngeal nerve).
